I’ve had some sort of online writing outlet for years, I think since freshman year of college: first I had a pitas account, then LJ I think. In high school I used spiral bound notebooks as a journal, the kind you buy for school notes. They’ve always been updated only sporadically, because blogging has yet to fit into the rhythms of my life the way I think it should. So why not quit entirely? It’s not like I’m a compulsive sharer–barely active on facebook, dormant profiles on some other social media sites. I could kill this site and no one would be the wiser.

And yet. There are days when I need to write. They may be few and far between, especially when life is pleasantly busy and full, and things are sunny. But there are always those days, when I am not quite able to put my finger on why I feel moody and angsty and fifteen again. Or days like today, when I know what it is, but don’t have anyone to talk it out with, for moral support and reassurance that this too shall pass.

They say that there’s a U-shaped curve in medical training. You start idealistic and motivated to help people. But over the months and years, as you are chronically tired and see so many patients, many of whom are demanding or narcissistic or have health problems of their own making, you lose empathy and compassion. Gradually, as you reemerge on the other side of the tunnel, you start to regain those better qualities.

For a long time I thought I was doing well avoiding the U. I mostly enjoyed med school, and even though there were rough stretches, there was usually enough downtime in between to reflect and recharge. And the first few months of intern year were like that for me as well. But right now, I feel like my meter is just about empty. My last couple months I had too many sad cases too close together–young patients with cancer, patients who came in that we thought we could fix, and ended up deteriorating unexpectedly and being made CMO. That, coupled with a higher-than-usual census and trying to get ready for the holidays, left me exhausted when last block ended. And now I’m in the ER, and most of the patients are not sick in the same way, and even though they have pain, or nausea or whatever, I just am finding it hard to care that much. I want to tell them, just tough it out, because they’re young and healthy and will get better one way or the other.

And the worst part is, I don’t have anyone to talk to about this. I’ve made the mistake of talking about patients dying a few times, with my husband or close friends, and…the conversation dries up. It’s not their fault, but they don’t have anything to tell me that makes me feel better. I’ve always been happy that most of my relationships are outside of medicine, because it’s easier to break out of the work bubble, but I’m starting to realize that there are disadvantages too.

And that’s why I need this space. So I can write, and don’t have to worry about making people feel uncomfortable. So I can say what’s on my mind, and not feel judged. So I’ll be here, on this blog, for a little while longer. At least until I figure out a better solution for dealing with these days.